Healthcare Provider Details

I. General information

NPI: 1265546451
Provider Name (Legal Business Name): CENTRAL CALIFORNIA EMERGENCY MEDICINE PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 11/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 OLD RIVER RD
BAKERSFIELD CA
93311-9781
US

IV. Provider business mailing address

PO BOX 20577
BAKERSFIELD CA
93390-0577
US

V. Phone/Fax

Practice location:
  • Phone: 661-632-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RONALD OSTROM
Title or Position: CFO
Credential: D.O.
Phone: 661-632-5000